About the service:

No Place Like Home is a domiciliary care agency that provides personal care for people living in their own homes in Canterbury, Herne Bay, Whitstable, Faversham and Sittingbourne and surrounding areas. The aim of the service is to help people make the most of later life through providing companionship, developing confidence and tailoring the service to people’s wishes. The service supports older people and specialises in caring for people living with dementia by providing minimum two hourly visits. At the time of this inspection the service was providing care for 11 people.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

People’s experience of using this service:

The service continued to be exceptionally effective, responsive and well-led. Staff had worked continuously to further develop and nurture these areas and the areas of safe and caring. As a result, it provided an exceptionally outstanding service for the benefit of people and their family members.

The service met its mission and values to help people make the most of later life through growing people’s confidence and providing companionship designed around their needs and wishes. A relative told us, “The provider explained the mission and values of the service. It has been that organisation and delivered 100% on it”.

Staff had outstanding skills and an excellent understanding of people’s individual preferences. Staff training was developed and delivered around people’s individual needs and this had made a significant impact on people’s quality of life. A relative told us, “I started in a situation where I was upset. But having found this agency it made me realise that dementia is not the end of the world. You can live with it. I couldn’t speak highly enough of them”.

There was a strong, visible person-centred culture. Developing positive and trusting relationships with people was at the heart of the service. Time was invested in making sure that staff employed shared the values of the service and in matching them with the interests and personality of the people they supported. A relative told us, “I am overwhelmed with the wonderful care. The service is set up like a family who is going to do the right thing”. A health care professional said, “The ethos and ethics of the team wholly reflect the need for person centred care that responds to individual needs. The whole team have quickly grasped the crux of situations and have always done their utmost to provide the correct level of support as quickly as possible, ensuring that they match the right people for the best outcomes”.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff had real empathy for the people they cared for and went ‘the extra mile’. A relative told us, “They were caring all the way up to and after mum’s funeral. They kept popping in to see if we were OK. They are authentic and compassionate”.

The service was an important part of its community and had developed links to reflect the needs of people. It worked with charities, health and social care professionals and engaged and acted on research to deliver improved outcomes and experiences for people.

Rating at last inspection: OUTSTANDING (Report published 29 July 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service has improved in two domains and all domains are now outstanding. .

Follow up: We will continue to monitor this service and plan to inspect in line with our reinspection schedule for those services rated Outstanding.

We inspected this service on 16 and 17 May 2016. The inspection was announced. The provider was given two working days’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be available at the locations office to see us.

No Place Like Home is a small domiciliary care agency that provides personalised home support service for Canterbury and Swale senior residents. The primary purpose of No Place Like Home is to provide companionship, tailored to each person’s wishes, and the secondary purpose is to provide personal care. No Place Like Home specialises in supporting people to live well with dementia and the majority of current clients are affected by dementia to a greater or lesser extent. Most people supported by No Place Like Home live in their own homes but some are local care home residents. At the time of this inspection the agency was providing a service to 17 people. Visits were a minimum of two hours and the frequency varied depending on people’s individual needs.

During our inspection the registered manager and the provider were present. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The feedback we received from people and their representatives was excellent. Those people that used the service and their representatives expressed great satisfaction and spoke very highly of the provider, registered manager and the personal assistants (staff). Everyone within the organisation was highly motivated and committed to ensuring people that used the service ‘made the most of later life.’ Staff were supported to develop and progress within their role by the provider and registered manager.

The safety of people using the service was taken seriously by the registered manager and staff who understood their responsibility to protect people’s health and well-being. Staff, the registered manager and the provider had received training about protecting people from abuse, and they knew what action to take if they suspected abuse. Risks to people’s and staff’s safety both internally and externally to the person’s home had been assessed and recorded, with measures put into place to manage any hazards identified. Staffing levels were kept under review to ensure staff were available to meet people’s assessed needs.

Staff had a full understanding of people’s care and support needs and had the skills and knowledge to meet them. People received consistent support from the same personal assistants who knew them well. The provider used innovative ways to develop the staff’s understanding of the complexities of supporting people who have dementia.

Staff were trained to meet people’s needs. Robust induction and matching processes were in place to ensure staff were able and confident to meet people’s needs. The provider encouraged staff to undertake additional qualifications to develop their skills. Staff were matched to people who had similar interests to enable people to continue with activities they enjoyed.

Recruitment practices were safe and checks were carried out to make sure staff were suitable to work with people who needed care and support. Personality profiling was used as a tool to match staff to people prior to an initial meeting.

People’s needs had been assessed to identify the care and support they required, including personality preferences for the staff who would be supporting them. Care and support was planned with people and their representative’s and regularly reviewed to make sure people continued to have the support they needed. Detailed guidance was provided to staff within people’s homes about how to provide all areas of the care and support people needed. People’s nutritio

The agency was currently providing care to five people. We spoke with the provider and manager at the time of the visit to the agency office. We contacted one member of staff and relatives of two people that used the agency services by telephone.

People spoke positively about the agency, with comments such as “The staff that provides the support is very good. X is reliable and always on time”. And “Very happy with personal assistant, we get on very well indeed”.

People were given all the information they needed to make an informed decision about their treatment, and were asked to sign their consent to their treatment.

We found that the agency had obtained suitable information from people to provide effective levels of care to meet their assessed needs. The support plans were detailed and informative.

People were visited by staff who were appropriately trained and supervised in order that people’s individual care needs could be met.

We saw that there were monitoring processes in place that ensured that people were protected against the risks of inappropriate or unsafe care and treatment as the service regularly assessed and monitored the quality of the service provided.